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Background: Skin neoplasms, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are prevalent forms of skin malignancies. To enhance accurate diagnosis, non‐invasive techniques including high‐frequency ultrasound (HFUS) are crucial. HFUS offers deeper penetration compared to reflectance confocal microscopy (RCM), and optical coherence tomography (OCT), making it valuable for examining skin structures. The aim of this study was to investigate and diagnose localized manifestation of BCC and SCC with HFUS and compare it with pathology results in patients referred to Razi Hospital, Tehran, Iran. Method and materials: This study included patients diagnosed with BCC and SCC, with clinical and pathological confirmation, attending the oncology clinic of Razi Hospital, Tehran, Iran, from 2022 to 2023. Exclusion criteria comprised metastatic and recurrent cases, patients who underwent treatment or surgery, and tumors located in anatomically challenging areas. HFUS with a 20 MHz probe and Doppler ultrasound were employed to examine the skin. Tumors were subsequently excised, fixed in formalin, and sent for pathological assessment. Ultrasound findings were compared with pathology results. Results: The study assessed 40 patients, with half diagnosed with SCC and the other half with BCC. The majority of SCC patients were male (80%), while BCC patients were relatively evenly divided between males (65%) and females (35%). The mean age was 59.15 ± 11.9 years for SCC and 63.4 ± 8.9 years for BCC. Cheeks (20%) and lips (35%) were the most common sampling sites for BCC and SCC, respectively. The correlation coefficients for tumor size and depth between ultrasound and pathology were 0.981 and 0.912, respectively, indicating a high level of agreement between the two methods. Conclusion: In BCC patients, there was complete agreement between sonographic loco‐regional extension and pathology findings. However, some discordance (30%) was observed in SCC cases. The study demonstrated a strong correlation between ultrasound and pathology in accurately detecting the depth and extent of the tumor. However, due to the inclusion of only patients with positive pathology, it is not appropriate to evaluate the diagnostic test values and compare them with pathology results. Therefore, it is highly recommended to carry out additional studies with larger sample sizes to further validate these findings. [ABSTRACT FROM AUTHOR]

Background: Localized scleroderma, known as morphea, is a connective tissue disorder characterized by inflammation and fibrosis of the skin and the soft tissue. There exist no universally accepted validated outcome measures in order to monitor the disease activity. Besides clinical scores to evaluate outcome measures, imaging modalities are increasingly utilized in assessing patients with morphea, such as high‐frequency ultrasonography (US), shear‐wave elastography (SWE), and magnetic resonance imaging (MRI). However, the accuracy of these imaging modalities in monitoring morphea activity is not yet clear. Aims: To review the literature regarding the role of imaging modalities in assessing patients with morphea. Materials & Methods: In this study, we searched the PubMed/Medline database for articles published from inception until February 2023. Results: A total number of 23 original articles in three categories of US, elastography, and MRI were included. Discussion: Regarding US, criteria, including increased dermal thickness, increased echogenicity of the subcutaneous tissue, and decreased dermal echogenicity, were indicators of active morphea lesions when using high frequencies probe (18–20 MHz) color Doppler sonography. Moreover, studies evaluating SWE, a novel method to quantitatively assess tissue stiffness, demonstrated increased dermal stiffness in active lesions. Conclusion: Studies showed that MRI can help to determine the depth of disease, particularly as a first‐line and follow‐up diagnostic tool, especially in generalized and deep morphea. In addition, brain MRI may be useful for patients with localized craniofacial scleroderma experiencing new or worsening neurological symptoms. [ABSTRACT FROM AUTHOR]

Background: Knowledge of normal facial vascular variations could prevent catastrophic complications of cosmetic procedures as well as providing a guide for surgical planning. Color Doppler ultrasound is a safe and noninvasive method for real time vascular evaluation. Objective: The aim of this study was to evaluate the normal variations of the facial, angular, transverse facial, supratrochlear and supraorbital arteries in a sample of normal individuals. Methods: Normal individuals referred for dermal filler injection to the tertiary dermatologic center, were selected. Patients who were smoker or had a history of facial filler injection, facial surgery, or trauma were excluded from the study. Facial artery at three levels as well as angular, supratrochlear, supraorbital, and transverse facial arteries were evaluated by an 18 MHz ultrasound linear probe regarding their distance from facial reference lines and landmarks, and also their depths in various regions of face. Results: A total number of 43 individuals were evaluated in this study. Thirty‐one (72.1%) were women. The number of absent facial artery was zero in level one, three (3.48%) in level two, and nine (10.46%) in level three. The angular artery was absent in 10 (11.62%) participants. The transverse facial artery was absent in 27 (31.39%) assessed individuals. Distance from reference lines at level 2 and 3 of facial artery and its depth at level 2 were significantly different between left and right side (p‐values: <0.001, 0.01, and 0.03, respectively). No significant difference was seen between depth and distance of two sides for angular and transverse facial arteries. The comparison of the depths and distances from the reference lines of the assessed arteries between two sexes revealed only a significantly greater value of facial artery distance in level 1 in males (p‐value: 0.001). BMI was also significantly correlated with the depth of facial artery in level 2 (Pearson correlation coefficient = 0.471, p‐value = 0.002) and level 3 (Pearson correlation coefficient = 0.357, p‐value = 0.03) and the distance of the facial artery in level 1 (Pearson correlation coefficient = 0.333, p‐value = 0.029). Conclusions: Color Doppler ultrasound could be used to map the arteries of face to prevent vascular complications and safely guide cosmetic procedures. [ABSTRACT FROM AUTHOR]

Background and Aims: Anal fistula (AF) with cryptoglandular origin tends to recur, and multiple risk factors are implicated. Recently, some magnetic resonance imaging (MRI) findings with predictive value for disease outcomes have been proposed. These intrinsic anatomic features include those of the AF and its surrounding structures. This study aims to clarify the prognostic role of MRI in AF. Methods: We performed a systematic search of PubMed, Embase, and EBSCO databases. Two independent reviewers conducted the search and screened the articles. We selected studies that used MRI to assess AF and reported its relationship to disease outcome. We extracted data regarding the study design, type of intervention, outcome, MRI‐measured items, and their significance. Results: Out of 1230 retrieved articles, 18 were eligible for final inclusion, and a total of 4026 patients were enrolled in the selected studies. For preoperative MRI, the significant items affecting the outcome were the length of the fistula, horseshoe type, presence of multiple tracts, supralevator extension, and apparent diffusion coefficient (ADC) value. Other studies investigated the healing process using postoperative MRI. Conclusion: This review found that MRI can be useful in the management of AF, both preoperatively and postoperatively. Factors, such as fistula length, horseshoe type, presence of multiple tracts, supralevator extension, and ADC value were found to be significantly associated with treatment outcomes. The presence of the fistula tract and the development of new abscesses on postoperative MRI was found to hinder the healing process. Further studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Research ethics training during post-graduate education is necessary to improve ethical standards in the design and conduct of biomedical research. We studied quality and quantity of research ethics training in the curricula of post-graduate programs in the medical science in I.R. Iran. We evaluated curricula of 125 post-graduate programs in medical sciences in I.R. Iran. We qualitatively studied the curricula by education level, including the Master and PhD degrees and analyzed the contents and the amount of teaching allocated for ethics training in each curriculum. We found no research ethics training in 72 (58%) of the programs. Among the 53 (42%) programs that considered research ethics training, only 17 programs had specific courses for research ethics and eight of them had detailed topics on their courses. The research ethics training was optional in 25% and mandatory in 76% of the programs. Post-graduate studies that were approved in the more recent years had more attention to the research ethics training. Research ethics training was neglected in most of the medical post-graduate programs. We suggest including sufficient amount of mandatory research ethics training in Master and PhD programs in I.R. Iran. Further research about quality of research ethics training and implementation of curricula in the biomedical institutions is warranted. [ABSTRACT FROM AUTHOR]

Aim Gestational trophoblastic neoplasm ( GTN) is a rare disease which is classified into high- and low-risk groups. While the high-risk patients require combination therapy, the low-risk groups respond to single-agent chemotherapy. We studied resistance to single-agent chemotherapy and its risk factors among the low-risk GTN patients in Iran. Methods We followed 168 low-risk GTN patients who were treated between 2001 and 2011 in Valiasr Hospital, Tehran, Iran. We used a case-control design and studied odds ratios ( OR) and corresponding 95% confidence intervals ( CI) to evaluate association between drug resistance and different personal and clinical variables. Results Resistance to sequential single-agent chemotherapy was 19%, although all patients had a complete remission after a combination of chemotherapy and/or surgery. Patients who had International Federation of Gynecology and Obstetrics scores of 5-6 - considered as, the intermediate risk group - had a 14-fold higher resistance compared with the low score patients ( OR = 14.28, 95% CI = 5.54-36.81). We found higher risk of resistance among patients with metastasis ( OR = 8.42, 95% CI = 2.44-29.07), large tumor size (>3 cm) ( OR = 7.73, 95% CI = 1.93-30.91), high β-h CG (>100 000 IU/L) ( OR = 5.86, 95% CI = 1.07-32.02) and/or a diagnosis more than 4 months after pregnancy ( OR = 3.30, 95% CI = 1.08-10.02), compared with their reference group. We found no priority for the different chemotherapy regimens. Conclusion Intermediate risk GTN patients had a higher risk of resistance to chemotherapy compared with low-risk patients. Clinical trials and cost-effectiveness studies are needed to suggest a better treatment program for the intermediate risk group. [ABSTRACT FROM AUTHOR]